3R7-30776-26185

5 vaccinations 8 coded responses 20 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 201 / VA
Registered: 2021-03-10

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-09
Dose 1 — Moderna
2021-03-10
Registered in v-safe
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Fatigue or tiredness, Nausea

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Survey response — day 14, dose 2
MedDRA: Asthenia, Headache, Nausea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Headache, nausea, no energy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Nausea, Vision blurred — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Tired, headache, nauseous, blurry vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 21, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache, Hypoaesthesia, Muscular weakness, Vision blurred — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache, blurry vision, extreme fatigue and arm/leg weakness and numbness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 35, dose 2
MedDRA: Headache, Hypoaesthesia, Nausea, Paraesthesia, Vision blurred, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Nausea, vomiting, headache, blurry vision, numbness and tingling in arms and legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-09-14
Dose 3 — Moderna
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Asthenia, Fatigue, Office visit, Oxygen saturation decreased, Vision blurred — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Oxygen level drops during sleep, vision blurry, tired and no energy. · Healthcare visit (other): Visits to Primary Care, Transplant team, Pulmonologist and Infectious Disease

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-10-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-15
Survey response — 6 months, dose 3
MedDRA: Cardiac failure congestive — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Diagnosed with CHF

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-03-17
Call successful
Participant prefers to complete VAERS report online
2022-03-23
Dose 4 — Moderna
2022-09-29
Dose 5 — Pfizer-BioNTech
Co-administered: Shingles:Tetanus
2022-10-08
Survey response — day 7, dose 5
MedDRA: Lethargy, Pain in extremity, Pyrexia — Feeling: Good

Free text: I did have low grade fever, pain in both arms (3 shots in one day) and was very lethargic for 3 days starting Sept 30th. I am fine now.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-09-14	Moderna	No
4	2022-03-23	Moderna	No
5	2022-09-29	Pfizer-BioNTech	Shingles:Tetanus

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): No

Release 7 — day 14, dose 2

2021-04-22

Symptoms: Headache, nausea, no energy

Release 8 — day 21, dose 2

2021-04-27

Symptoms: Tired, headache, nauseous, blurry vision

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Headache, blurry vision, extreme fatigue and arm/leg weakness and numbness

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Nausea, vomiting, headache, blurry vision, numbness and tingling in arms and legs

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Oxygen level drops during sleep, vision blurry, tired and no energy.

Healthcare visit (other): Visits to Primary Care, Transplant team, Pulmonologist and Infectious Disease

Release 11 — 6 months, dose 3

2022-03-15

Symptoms: Diagnosed with CHF

Release 12 — day 7, dose 5

2022-10-08

Systemic reaction (other): I did have low grade fever, pain in both arms (3 shots in one day) and was very lethargic for 3 days starting Sept 30th. I am fine now.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Office visit	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Cardiac failure congestive	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oxygen saturation decreased	·	·	✓
SD	Paraesthesia	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Lethargy	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Pyrexia	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release